title: Characteristics, processes, management and outcome of accesses to accident and emergency departments by citizenship.
abstract: OBJECTIVE
  The aim of this study was to analyze the characteristics of accident and emergency department (A and E) access, process management and outcome after grouping patients by their citizenship.
  
  
  METHODS
  The study was conducted using the recorded linkage database at a local public health agency in north-east Italy. We investigated 35,541 adult patients (18-65 years) accessing the A and E.
  
  
  RESULTS
  An underutilization of primary care services and the use of A and E for nonurgent conditions is a problem affecting all nationalities, natives included. The length of the stay in A and E and the consistency between level of urgency and priority of the visits at entry and exit triage were similar for all citizenship groups. Illegal migrants were more frequently hospitalized after A and E visits than other groups.
  
  
  CONCLUSIONS
  The potentially inappropriate use of A and E for non-urgent conditions was common among all the patient groups considered and barriers to primary care may enhance this behavior among migrants. This situation could also explain the higher odds ratio for migrants' hospitalization and discharge to ambulatory services after A and E visits.
authors.affiliation: Department of Molecular Medicine of the University of Padova, Laboratory of Public Health and Population Studies, Via Loredan 18, 35121, Padua, Italy, alessandra.buja@unipd.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Buja
authors.forename: Marco
authors.initials: M
authors.lastname: Fusco
authors.forename: Patrizia
authors.initials: P
authors.lastname: Furlan
authors.forename: Chiara
authors.initials: C
authors.lastname: Bertoncello
authors.forename: Tatjana
authors.initials: T
authors.lastname: Baldovin
authors.forename: Patrizia
authors.initials: P
authors.lastname: Casale
authors.forename: Adriano
authors.initials: A
authors.lastname: Marcolongo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Baldo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D055815:Young Adult